Myopia in the COVID-19 Pandemic Period in Young Adults: The Sample of Turkey-Zonguldak

Öz

Aim: Investigating the relationship between the development and progression of myopia and digital screen time in young adults during the COVID-19 pandemic. Material and Methods: This single-centered, retrospective study included 106 young adults aged 18- 25 years, followed up in January-March 2019, 2020, and 2021. The patients were divided into two groups: emmetrope and myopia according to their baseline refractive values. The association between spherical equivalent refraction (SER) values and digital screen time before and during the pandemic was evaluated. Results: The mean age of 59 patients‘ (69.5% female) in the emmetrope group was 20.7±2.0, and 20.6±2.3 years of 47 patients (68.1% female) in the myopia group (p=0.422, p=0.877, respectively). The patients were reported to spend more time on digital devices in both groups (p<0.001). Before the pandemic, the SER value did not differ between 2019 and 2020, but the average annual change in SER was -0.19±0.34 D in the pandemic between 2020-2021 for the emmetrope group (p<0.001).The mean annual change of SER was -0.08±0.19 D between 2019-2020 and -0.21±0.26 D in the myopia group during the pandemic (p=0.015). The annual change of SER was under 0.50 D for both, and a significant correlation was not detected between the increase in digital screen time and the change in SER in the emmetropic and myopic groups. Conclusion: The increased usage of digital devices during the pandemic is not associated with a myopic shift in young adults. Although no correlation was found, a shift to myopia was detected in both groups during the pandemic.

Anahtar Kelimeler

• Adult myopia
• COVID-19 pandemic
• digital screen
• myopia
• progression of myopia

Genç Yetişkinlerde COVID-19 Pandemisi Dönemi Miyopi: Türkiye-Zonguldak İli Örneği

Öz

Amaç: Genç erişkinlerde pandemi döneminde dijital ekran kullanım süresi ile miyopi gelişimi ve miyopi progresyonu arasındaki ilişkiyi araştırmak. Gereç ve Yöntemler: Retrospektif, tek merkezli çalışmamıza Ocak-Mart 2019, 2020 ve 2021 yıllarında takip edilen 18-25 yaş arası 106 genç yetişkin dahil edildi. Başvurudaki sferik eşdeğer refraksiyon (SER) değerlerine göre hastalar emetrop ve miyop olmak üzere iki gruba ayrıldı. Pandemi öncesinde ve pandemi döneminde SER değişiklikleri ile dijital ekran kullanım süresi arasındaki ilişki değerlendirildi. Bulgular: Emetrop gruptaki 59 hastanın (%69.5'i kadın) yaş ortalaması 20.7±2.0, miyop grubundaki 47 hastanın (%68.1'i kadın) yaş ortalaması 20.6±2.3 idi (sırasıyla; p=0.422, p=0.877). Her iki grupta da hastaların dijital cihazlarda daha fazla zaman geçirdikleri saptandı (p<0.001). Emetrop grupta pandemi öncesi SER değeri 2019-2020 yılları arasında farklılık göstermezken, 2020-2021 pandemi yılları arasında SER’deki ortalama yıllık değişim -0.19±0.34 D idi (p<0.001). Miyop grupta SER’deki ortalama yıllık değişim 2019-2020 yılları arasında -0.08±0.19 D ve pandemi dönemimde -0.21±0.26 D idi (p=0.015). Yıllık SER değişimi iki grupta da 0.50 D’nin altındaydı ve iki grupta da dijital ekran süresindeki artış ile SER değişimi arasında anlamlı bir korelasyon saptanmadı. Sonuç: Pandemi döneminde dijital cihazların artan kullanımı, genç erişkinlerde miyopi gelişimi ve artışıyla korele değildir. Korelasyon saptanmamış olsa da her iki grupta da pandemi döneminde miyopiye kayma saptanmıştır

Anahtar Kelimeler

• Erişkin miyopisi
• COVİD-19 pandemisi
• dijital ekran
• miyopi
• miyopi progresyonu

Kaynakça

1. 1. Holden BA, Mariotti SP, Kocur I, Resnikoff S, Mingguang H, Naidoo K, Jong M. The impact of myopia and high myopia. Report of the Joint World Health Organization–Brien Holden Vision Institute Global Scientific Meeting on Myopia. World Healt h Organization, Geneva, Switzerland. 2015.
2. 2. Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, Wong TY, Naduvilath TJ, Resnikoff S. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology 2016;123:1036-42.
3. 3. de Jong P. Myopia: its historical contexts. Br J Ophthalmol 2018;102:1021-27.
4. 4. Saxena R, Vashist P, Tandon R, Pandey RM, Bhardawaj A, Gupta V, Menon V.. Incidence and progression of myopia and associated factors in urban school children in Delhi: The North India Myopia Study (NIM Study). PloS one 2017;12:e0189774.
5. 5. Wen L, Cao Y, Cheng Q, Li X, Pan L, Li L, Zhu H, Lan W, Yang Z. Objectively measured near work, outdoor exposure and myopia in children. Br J Ophthalmol 2020;104:1542-1547.
6. 6. He M, Xiang F, Zeng Y, Mai J, Chen Q, Zhang J, Smith W, Rose K, Morgan IG. Effect of Time Spent Outdoors at School on the Development of Myopia Among Children in China: A Randomized Clinical Trial. Jama 2015;314:1142-1148.
7. 7. Ozturk Eyimaya A, Yalçin Irmak A. Relationship between parenting practices and children's screen time during the COVID-19 pandemic in Turkey. J Pediatr Nurs 2021;56:24-29.
8. 8. Sumitha M, Sanjay S, Kemmanu V, Bhanumathi MR, Shetty R. Will COVID-19 pandemic-associated lockdown increase myopia in Indian children? Indian J Ophthalmol 2020;68:1496.

9. 9. Wong CW, Tsai A, Jonas JB, Ohno-Matsui K, Chen J, Ang M, Ting DSW. Digital Screen Time During the COVID-19 Pandemic: Risk for a Further Myopia Boom? Am J Ophthalmol 2020;223:333-337.
10. 10. Pellegrini M, Bernabei F, Scorcia V, Giannaccare G. May home confinement during the COVID-19 outbreak worsen the global burden of myopia? Graefes Arch Clin Exp Ophthalmol 2020;258:2069-2070.
11. 11. COMET Group. Myopia stabilization and associated factors among participants in the Correction of Myopia Evaluation Trial (COMET). Invest Ophthalmol Vis Sci 2013;54(13):7871-7884.
12. 12. Wang J, Li Y, Musch DC, Wei N, Qi X, Ding G, Li X, Li J, Song L, Zhang Y, Ning Y, Zeng X, Hua N, Li S, Qian X. Progression of Myopia in School-Aged Children After COVID-19 Home Confinement. JAMA Ophthalmol 2021;139:293-300.
13. 13. Ma M, Xiong S, Zhao S, Zheng Z, Sun T, Li C. COVID-19 Home Quarantine Accelerated the Progression of Myopia in Children Aged 7 to 12 Years in China. Invest Ophthalmol Vis Sci 2021;62:37.
14. 14. Aslan F, Sahinoglu-Keskek N. The effect of home education on myopia progression in children during the COVID-19 pandemic. Eye (Lond) 2021;1-6.
15. 15. Lee SS, Lingham G, Sanfilippo PG, Hammond CJ, Saw SM, Guggenheim JA, Yazar S, Mackey DA. Incidence and Progression of Myopia in Early Adulthood. JAMA Ophthalmol 2022;140:162-169.
16. 16. Grzybowski A, Kanclerz P, Tsubota K, Lanca C, Saw SM. A review on the epidemiology of myopia in school children worldwide. BMC Ophthalmol 2020;20:27.
17. 17. Enthoven CA, Tideman JWL, Polling JR, Yang-Huang J, Raat H, Klaver CCW. The impact of computer use on myopia development in childhood: The Generation R study. Preventive Medicine 2020;132:105988.
18. 18. Mccrann S, Loughman J, Butler JS, Paudel N, Flitcroft DI. Smartphone use as a possible risk factor for myopia. Clin Exp Optom 2021;104:35-41.
19. 19. Lanca C, Saw SM. The association between digital screen time and myopia: A systematic review. Ophthalmic Physiol Opt 2020;40:216-229.
20. 20. Smith EL, 3rd, Hung LF, Huang J. Protective effects of high ambient lighting on the development of form-deprivation myopia in rhesus monkeys. Invest Ophthalmol Vis Sci 2012;53:421- 428.
21. 21. Ashby RS, Schaeffel F. The effect of bright light on lens compensation in chicks. Invest Ophthalmol Vis Sci 2010;51:5247-5253.
22. 22. Morgan IG, French AN, Ashby RS, Guo X, Ding X, He M, Rose KA. The epidemics of myopia: Aetiolo